Relation Between Coronary Artery Disease, Risk Factors and Intima-Media Thickness of Carotid Artery, Arterial Distensibility, and Stiffness Index

Abstract

Atherosclerosis is a diffuse process that involves vessel structures. In recent years, the relation of noninvasive parameters such as intima-media thickening (IMT), arterial distensibility (AD), and stiffness index (SI) to cardiovascular diseases has been researched. However, we have not found any study that has included all these parameters. The aim of this study is to examine the relation between the presence of coronary artery disease (CAD) and its risk factors to AD, SI, and IMT, which are the noninvasive predictors of atherosclerotic process in the carotid artery. Included in the study were 180 patients who were diagnosed as having CAD by coronary angiography (those with at least > or = 30% stenosis in the coronary arteries) and, as a control group, 53 persons who had normal appearing coronary angiographies. IMT, AD, and SI values of all the patients in the study were measured by echo-Doppler imaging (AD formula = 2 x (AoS - AoD)/PP x AoD, SI formula = (SBP/DBP)/([AoS - AoD]/AoD). Significantly increased IMT (0.82 +/- 0.1, 0.57 +/- 0.1, p<0.05), decreased AD (0.25 +/- 0.9, 0.37 +/- 0.1, p<0.05), and increased SI (13 +/- 4, 8 +/- 3, p<0.05) values were detected in the CAD group compared to the control group. A significant correlation was found between IMT and presence of diabetes mellitus (DM), systolic blood pressure, total cholesterol, and presence of plaque in carotids, and age. In the coronary artery disease group there was a significant correlation between AD and age, systolic blood pressure, and HDL cholesterol levels, while there was no significant correlation with plaque development. A significant correlation was also found between stiffness index and systolic blood pressure and age; however, there was no relation between number of involved vessels and IMT, AD, and SI. We found sensitivity, specificity, and positive predictive and negative predictive values for CAD diagnosis to be 70%, 75%, 77%, and 66%, respectively. In CAD cases, according to data in this study, IMT and SI increased while AD decreased, and this was detected by carotid artery Doppler ultrasonography. Therefore, it was concluded that these cheaper, noninvasive, and easily available parameters could be used in early diagnosis of CAD.

The Combination of IMT and Stiffness Parameter .BETA. is Highly Associated with Concurrent Coronary Artery Disease in Type 2 Diabetes

“…Hirai et al first demonstrated that stiffness parameter of CA and aorta increased with the number of stenoses of coronary arteries as determined by CAG 17) . Alan et al found that IMT and stiffness parameter in the CAD group were higher than those in the control group, and that the sensitivity, specificity, and positive predictive and negative predictive val- ues of IMT for angiographic CAD diagnosis were 70%, 75%, 77%, and 66%, respectively 18) . In elderly men, stiffness parameter was also found to be a significant predictor of cardiovascular mortality (HR, 1.68) during 48-month follow-up 19) .…”

“…Stiffness parameter is unique among these indices since it features correction for the ratio of systolic and diastolic blood pressures and minimal effects of acute changes in blood pressure 16,17) . Increased stiffness parameter of the carotid artery and/or aorta has been reported to be associated with CAD 15,[17][18][19] . We have also demonstrated that stiffness parameter is increased in diabetic patients with chronic kidney disease 20) , latent symptoms of peripheral artery disease 21) , insulin resistance 22,23) , and hypoadiponectinemia 24) .…”

Relationship between carotid artery stiffness index, BNP and high-sensitivity CRP

“…2 Arterial stiffness has been consistently proven to be a predictor of adverse cardiovascular outcomes. 3 Stiffness index b is a measure of carotid arterial stiffness that is associated with coronary atherosclerosis 4,5 and vascular dysfunction 6 in patients with glucose intolerance and insulin resistance.…”

Intervention Study on the Exercise Order of Combined Aerobic & Resistance Training in the Elderly

“…Arterial stiffness increases with advancing age [7], and is as an emerging biomarker in the assessment of vascular health [40]. Large arterial stiffness is associated with an increased risk for coronary heart disease [8], hypertension [9], left ventricular hypertrophy, diastolic dysfunction [10,11] and all-cause mortality [12]. However, although aerobic exercise effectively decreases arterial stiffness, it does not induce gains in strength and lean body mass, as well as increases in bone density compared with resistance training [4,41].…”

“…Also, arteries lose their compliance with advancing age, independent of atherosclerosis, hypertension and other disease states [7]. This age-related reduction in central arterial compliance is associated with an increased risk for coronary heart disease [8], hypertension [9], left ventricular hypertrophy, diastolic dysfunction [10,11] and all-cause mortality [12].…”